BMJ  2006;332:1251-1255 (27 May), doi:10.1136/bmj.332.7552.1251

Clinical review

Management of hypertrophic cardiomyopathy

¹ Divisione di Cardiologia, Ente Ospedaliero Ospedali Galliera, Via Volta 8, Genoa 16128,Italy, ² Unità Operativa di Cardiologia, Ospedale Sant'Andrea, Università di Roma "La Sapienza", Via Grottarossa, 1035-1039, Rome 00189, Italy

The first 150 words of the full text of this article appear below.

Introduction

Hypertrophic cardiomyopathy is the most common familial genetic disease of the heart (1/500 to 1/1000), as well as the most common cause of sudden cardiac death in young people and athletes. Because a timely diagnosis may help to prevent sudden death, it is important for internists and general practitioners to be aware of the clinical features of the disease. The morphological and functional features of hypertrophic cardiomyopathy include marked and asymmetric left ventricular hypertrophy, a non-dilated left ventricular cavity, and preserved systolic function. Left ventricular outflow obstruction at rest is present in about 20% of patients.^1-3 The clinical course is heterogeneous. Many patients remain asymptomatic throughout life, others develop severe heart failure or atrial fibrillation, and some die suddenly, often at a young age and in the absence of previous symptoms.^1-3 We critically re-examine and place in perspective the most appropriate therapeutic strategies for the management of hypertrophic cardiomyopathy.

Sources and search criteria

This . . . [Full text of this article]

Diagnosis

-->-->

Treatment of symptoms

Pharmacological treatment of heart failure
-->Non-pharmacological treatment of heart failure due to outflow obstruction

Atrial fibrillation

Risk stratification and prevention of sudden death

-->Risk factors
Family history of sudden death
Extreme hypertrophy
Unexplained syncope
Non-sustained ventricular tachycardia
Abnormal blood pressure response to exercise
Low clinical risk profile

Prophylaxis of infective endocarditis

Pregnancy

Lifestyle

Family screening

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